According to the President's Commission on Consumer Protection and Quality in the Health Care Industry, ensuring full participation in care decisions is a fundamental right for all patients. Such access is frequently compromised for racial, ethnic, and cultural minorities and persons with limited English language proficiency. In addition, health care quality evaluation requires sensitivity to cultural competence, including diversity of patient perceptions and expectations across cultural groups. We propose to develop and validate a questionnaire to examine quality of care from the patients' perspective for Asian-Americans of Chinese and Vietnamese descent. Chinese and Vietnamese Americans are the fastest growing minority group nationwide. Many confront significant cultural, language and socioeconomic barriers to care, but their health care experiences have received little study. In collaboration with the Picker Institute and the Center for Survey Research, we will conduct separate focus groups involving Chinese and Vietnamese patients to identify issues important to patients, emphasizing measures of communication and access to care. Focus groups will be lead by moderators from the Chinese and Vietnamese communities, in their respective languages. Based on these findings, we shall draft a patient questionnaire and test its validity using standard, survey research methods. Subsequent field testing will involve linguistically and culturally-sensitive, face-to-face, patient interviews approximately one month after an outpatient visit. In addition, we shall compare survey responses to taped provider encounters. Once the instrument is finalized, we shall survey 4,000 Chinese and Vietnamese patients at 10 health centers nationwide which care for substantial Asian American populations. We shall also gather detailed information about structural characteristics of the 10 health centers (e.g., language competency, staffing) and compare patients' survey reports to various clinic attributes. The primary product of this study will be new ways to evaluate quality of care for Chinese and Vietnamese populations at risk because of language, cultural, and other barriers and will provide a template for developing future quality measures for other vulnerable populations.